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Final Flashcards

1
Q

Which of the following conditions usually originates at the lower portion of the anterior mediastinum

A

Teratoid cyst

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2
Q

Which 1 of the following criteria distinguish a thoracic spine series from a chest series

A

Frontal view
PA
72 inch FFD
100 kVp

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3
Q

A normal chest series

A

Shows lungs with blood vessels smaller in the upper lung and larger in the lower lung

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4
Q

A vanishing tumor or phantom tumor of the lung could be assocaited with

A

Cardiac disease related to systemic hypertension

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5
Q

With large pneumothorax, one might see

A

Absence of lung markings in teh involved hemithorax with same side passive atelectasis

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6
Q

Multiple small round calcifications in the liver and spleen suggest

A

Histoplasmosis

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7
Q

A patient presenting with stringy, irregular, linear upper left lung densities and retraction upward of the left hilus most likely has

A

TB primary

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8
Q

The most common cause for a Stanford Type A (Type II) aneurysm is Marfan’s syndrome

A

True

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9
Q

Middle mediastinal masses include

A

Bronchogenic cyst
Aortic aneurysm
Esophageal aclasia

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10
Q

TB, sarcoidosis, connective tissue diseases and pneumonconiosis all have ____ in common

A

Fibrosis

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11
Q

Signs of emphysema include

A

Low flat diaphragm, blunt ended costophrenic angles, hyperlucent lung

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12
Q

Which of the following are characteristic findings of mitral stenosis

A

Pulmonary edema, pulmonary venous hypertension, left atrial enlargement

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13
Q

A good diagnostic film for pleural effusion would be

A

Lateral decubitus with affected side down

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14
Q

Pancoast tumor is a

A

Bronchogenic cancer

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15
Q

Aortic coarctation

A

Enlarges the ascending aorta

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16
Q

Which of the following cannot be detected or evaluated on the abdominal plain films

A

GI mucosal detail

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17
Q

What percentage of malignant mesothelioma will be associated with asbestosis approximately

A

80%

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18
Q

A number of connective tissue diseases have been reported to occur with increased prevalence in patients with pneumonconiosis. The combination of coal workers pneumoconiosis and rheumatoid arthritis is referred to as

A

Caplan’s syndrome

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19
Q

A mycetoma would most likely be found within the lung; however, they can also be found in paranasal sinuses. Which of the following could mimic a mycetoma within the lung

A

Fungal cavitation

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20
Q

A patient with mechanical ileus will have a visible gas pattern int eh rectum where as the patient with a paralytic ileus typically will have no rectal gas

A

True

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21
Q

Which one of the following causes would be an example of pulmonary edema secondary to increased capillary permeability`

A

Heroin overdose

High altitude edema - inc permeability

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22
Q

Mitral stenosis

A

Inc pressure

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23
Q

Left atrial myxoma

A

Inc pressure

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24
Q

Congestive heart failure

A

Inc pressure

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25
Q

Hypertrophic osteoarthropathy is a syndrome and is most often a clinical indication of

A

Bronchogenic carcinoma

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26
Q

The pancoast syndrome consists of

A

Horner’s syndrome, arm pain, neck pain, apical pulmonary mass

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27
Q

Which condition clinically associated with acute onset of chest pain and difficulty breathing could have a normal chest x-ray

A

Thromboembolic disease

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28
Q

Indirect roentgen signs of lung collapse include all of the following except

A

Vascular or bronchial crowding (herniation of lung tissue, tracheal deviation, narrowed rib cage on collapsed side all included)

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29
Q

Eisenmenger physiology results in

A

Right to left shunting from shunt reversal and eventually right ventricular failure

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30
Q

Three direct signs of lung collapse, seen on plain film are

A

Increased lung opacity
Displaced fissures
Vascular or bronchial crowding

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31
Q

Calcified pelvic phlebolyths are very common and may be difficult to distinguish from

A

Urinary tract stones

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32
Q

A dynamic or paralytic ileus may be caused by

A

Spinal fracture or acute disc herniation

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33
Q

A meniscus sign may indicate

A

Free pleural effusion

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34
Q

A pelvic cyst having a very thin rim of calcium within the wall and multiple small irregular calcific densitites appearing like teeth is a diagnostic of

A

Ovarian teratoid cyst

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35
Q

Which cardiac examination does not utilize ionizing radiation

A

Echocardiogram

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36
Q

On a thoracic spine series, a pt was found to have a fusiform shaped mass denisty at the retrocardiac space on teh lateral view and a soft tissue density superimporsing the lower thoracic spine on the AP view. The differential would include all of the following except

A

Ectopic fibroid or foramen of morgagni hernia

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37
Q

An air-fluid level seen behind the heart on a PA and lateral chest x-ray is probably

A

Hiatal hernia

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38
Q

With large amounts of free pleural effusion

A

There may be a mediastinal shift to the unaffected side

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39
Q

The most sensitive chest film for pleural effusion is

A

The lateral decubitus view with trendelenburg positioning

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40
Q

Which of the following is associated with ASD and hypoplastic or nonfunctioning right ventricle

A

Tricuspid atresia

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41
Q

Which combination of defects would have a high volume left to right shunt called loop/loochenbacher’s syndrome

A

ASD with mitral stenosis

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42
Q

Which combination of imaging of choice for gall bladder disease is

A

Ultrasound

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43
Q

Which one of the following is associated with a common ventricle and a large single blood vessel leaving the heart

A

Truncus arteriosus

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44
Q

Cephalic shift in pulmonary vascularity associated with venous hypertension, in the pulmonary circulation causes large upper lung blood vessels, in the upright position which may equal the size of the lower lung blood vessels

A

True

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45
Q

Which one fo the following is non-cyanotic

A

Ebstein’s anomaly

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46
Q

Cyanotic

A

Tetralogy of fallot
Trilogy of fallot
Transposition of the great vessels
VSD + Eisenmenger

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47
Q

Which condition would not be considered a precursor for congestive heart failure

A

Pulmonary fibrosis - cor pulmonale

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48
Q

Which type of aortic dissection is most common and has the worst prognosis using the debeke and stanford classification

A

Type I

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49
Q

Which aortic dissection is the least common

A

Type II - marfan’s

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50
Q

What is the classic sign of pulmoanry arterial hypertenstion

A

Large pulmonary artery

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51
Q

Mitral stenosis may produce the radiographic appearance of

A

Left atrial enlargement (kerley B lines)

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52
Q

Mediastinal teratoma’s are usually located in which compartment

A

Anterior

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53
Q

Mediastinal hiatal hernias are located in which compartment

A

Middle

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54
Q

Chamber enlargement confined to the right atrium would be expected with which one of the following

A

Ebstein’s anomaly

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55
Q

Which primary malignancy is responsible for the greatest number of hematogenous metastatic cases

A

Breast cancer

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56
Q

Eisenmenger physiology converts a left to right shunt to a right to left shunt. T/f

A

True

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57
Q

Eisenmenger physiology is an insignificant complication of chronic left to right shunting. T/F

A

False

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58
Q

With regard to lung tumor staging, which of the following combinations of TNM has the worst prognosis

A

T1 N0 M0
Then T1 N0 M1
Then T4 N3 M0

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59
Q

Posterior eventration of the hemidiaphragm may be associated with which one

A

Foramen of bochadalek

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60
Q

Carcinoid tumor is the most common type of bronchialar carcinoma (it was bronchial adenoma)

A

True

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61
Q

Patent ductus arteriosus with eisenmenger physiology would have cyanosis

A

In the lower extremity only

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62
Q

In large bowel obstruction 60-80% of cases are related to tumors. Approximately 10% of cases are related to diverticular disease and approximately 5% of cases are related to volvulus. Sigmoid volvulus is much more common than cecal volvulus

A

True

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63
Q

Pulmonary infarction

A

Is seen as a pulmonary mass

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64
Q

The most common primary malignancy of the lung is

A

Bronchogenic carcinoma

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65
Q

Which of the following would not be the cause of left ventricular enlargement

A

ASD

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66
Q

With bowel obstruction, closed-loop obstructions are considered to be surgical emergencies because

A

Of high incidence of bowel infarction and perforation

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67
Q

Pneumocystis carinii pneumonia is a pulmonary infection

A

Most commonly seen in patients with immune system suppression - AIDS

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68
Q

Which of the following would not be the cause of right ventricular enlargement

A

Ebstein’s anomaly

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69
Q

The significance of porcelain bladder is

A

Increased risk of carcinoma

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70
Q

Calcification within the pancreas is usually associated with

A

Alcoholism

71
Q

Which cause of pleural effusion would be expected to produce an atypical effusion

A

Congestive heart failure

72
Q

All of the following must be considered in teh differential diagnosis of ???? Except

A

Hernia

73
Q

An increased incidence of cholelythiasis would be expected in pateints with

A

Diabetes mellitus

74
Q

Mechanicla ileus may be caused by

A

Cholelythiasis

75
Q

Gallstone ileus is caused by

A

A gall stone lodged at iliocecal valcve

76
Q

Emphysematous cholecystitis is strongly associated with

A

Diabetes mellitus

77
Q

Imaging of choice for a gall bladder is

A

Diagnostic abdominal ultrasound

78
Q

The most frequent cause of pneumoperitinium is

A

Ruptured gastric or duodenal ulcer

79
Q

The most common reasons for mediastinal lymph node calcifications include

A

Fungal infections and pneumoconiosis

80
Q

Hodgkins disease may create a radiologic appearance of

A

Bulky mediastinal widening

81
Q

Combination of kerley’s A and B lines, interstitial pulmonary edema and cephalic shift of pulmonary vascularization suggest a diagnosis of

A

Congestive heart failure

82
Q

Which of the following is not considered to be an associated cause of bronchogenic cancer

A

Previous histoplasmosis

83
Q

Esophageal achalasia may present as

A

A middle mediastinal mass

84
Q

Pulmonary arterial hypertension can be related to all of the following except

A

Tetralogy of fallot

85
Q

Posterior mediastinal masses may

A

Are associated with adjacent bone remodeling changes

86
Q

An air fluid level seen in the maxillary sinus on a vertex view is most likely related to

A

Acute sinusitis

87
Q

Posterior mediastinal masses include

A

Neurogenic tumors
Spinal disease
Aortic aneurysm

88
Q

All of the following must be considered in the differential diagnosis of Thymoma except

A

Hernia

89
Q

An increased incidence of cholelythiasis would be expected in patients with

A

Diabetes mellitus

90
Q

Mechanical ileus may be caused by

A

Cholelythiasis

91
Q

Gallstone ileus is caused by

A

A gall stone lodged at ilio cecal valcve

92
Q

Emphysemitus cholecystitis is strongly associated with

A

Diabetes mellitus

93
Q

Imaging of choic for gall bladder is

A

Diagnostic abdominal ultrasound

94
Q

The most frequent cause of pneumoperitonium

A

Ruptured gastric or duodenal ulcer

95
Q

Most common reasons for mediastinal lymph node calcification include

A

Fungal infectious and pneumoconiosis

96
Q

Hodgkin’s disease may create a radiologic appearance of

A

Bulky mediastinal widening

97
Q

Combination of kerley’s a and B lines interstitial pulmonary edema, and chalic shift of pulmonary vascularization suggest a diagnosis of

A

Congesative heart failure

98
Q

Which fo the follwoing si not considered to be an associated cause of bronchogenic cancer

A

Previous histoplasmosis

99
Q

Esophageal aclasia may present as

A

A middle mediastinal mass

100
Q

Pulmonary arterial hypertension can be related to all of the following except

A

Tetralogy of fallot

101
Q

Posterior mediastinal masses may

A

Are asosciated with adjacent bone remodeling changes

102
Q

An air fluid level seen in the maxillary sinus on a vertex view is most likely related to

A

Acute sinusitis

103
Q

Increased density and widening of the upper mediastinal with tracheal displacement would be consistent with

A

Substernal thyroid (thyrote)

104
Q

Clinical symptomology related to bronchogenic cancer is often times non-specific. What percentage of patients with lung cancer are asymptomatic at the time of diagnosis

A

25

105
Q

Pulmonary metastasis happens wthrough 3 mechanisms: hematogenous, lymphagenous, and contiguous direct extension. Direct extension pulmonary metastasis happns most commonly from

A

Pleural/pericardium

106
Q

Calcification within pulmonary metastatic nodules would suggest which type of primary cancer

A

Osteosarcoma

107
Q

Rectal gas helps to discriminate between paralytic/adyramic ilius and mechanic/obstructive ilius

A

True

108
Q

3 major mediasitnal organs are esophagus trachea and aorta. Mnost commonly middle mediastinal masses are from

A

Lymph nodes

109
Q

Hylar mediastinal lymphadenopathy is most often due to ___ in young patients and ___ in older patients

A

Sarcoidosis

Lung cancer

110
Q

The analogy of the basketball under the blanket or on top of the blandket helps differentiate lung lesions from

A

AOTA

111
Q

…mediastinum is indicative of what

A

Unithorax volume change

112
Q

Clinical suspicion of lobar pneumonia is confirmed by which imaging procedure intiially

A

Plain film

113
Q

Optimum imaging for pulmonary detail is what

A

Apical lordotic CT scanning

114
Q

Which of teh following signs would point to air space consolidation

A 
Bilateral medullary lung opacification
Subsegmental poorly defined opacity
5-8mm acinar nodules
Lobar opacification
Poorly defined segmental opacification
115
Q

A common cause for bronchopneumonia pattern is

A

Staph aureus

116
Q

Enlargement of bronchi secondary to destruction of the muscular elements and elastic fibers of the bronchial walls caused by chronic infectipon is referred to as

A

Bronchiectasis

117
Q

Which fo the following are signs of interstitial disease

A 
1-2mm nodules
Honeycomb densitites
3-5mm nodules
Reticulonodular densitites
Kerley lines
118
Q

Which fo the follwoing are signs assocaited with atelectasis

A

Vascular crowding
Hilar shift towards density
Rib interspace narrowing
Elevation of diaphragm

119
Q

Acute infectious pneumonias

A

Pneumococcal pneumonia
Staph aureus pne
Klebsieela pneu
Viral pneu

120
Q

TB pneumonia is acute infecious pneumonia

A

False

121
Q

Pulmonary consolidation in this segment can cause a silhouette sign with the ascending aorta

A

Anterior segement of RUL

122
Q

Kartageners is associated with which pulmonary disorder

A

Bronchiectasis

123
Q

Which cause of radiolucent pulmonary cystic cavitary type sapce is liekly to be seen in children

A

Pneumatocele

124
Q

Kelbsiella pneumonia may cause lobar consolidation however a classic cause is

A

Strep pneumonia

125
Q

Which of the following is NOT a hypersensitivity related disorder

A

Silo fillers disease - NO2

126
Q

Irritant gases and chemical produce which form of pulmonary disease

A

Lobar consolidation

127
Q

Which are considered to be fibrogenic pneumoconiosis

A

Silicosis
Asbestosis
Black lung disease
Beryllium grnaulomatosis

128
Q

Indirect signs of lung collapse are

A

Unilateral hemodiaphragm elevation
Mediastinal deviation
Rib interspace narrowing

129
Q

Sequelae of previous granulomatous infection include

A 
Calcified granuloma
Splenic calcificiation
Upper lung fibrosis
Calcified lymph nodes
Pleura calcification
130
Q

End stage silicosis is characterized by which radiographic finding

A

Ribrotic masses adjacent to upper mediastinum

131
Q

The gohn tuberculum is

A

A tuberculum granuloma

132
Q

Which are findings that can be assocaited with pulmonary TB

A

Lymphadenopathy

133
Q

Of teh acute infections, cavitation si most likely to be associated with

A

Staph aureus

134
Q

Multiple cystic radiolucencies scattered thorughout the lung field would not typically be associated with

A

Squamous cell carcinoma

135
Q

On a chest series the findings are: unilateral localized homogenous increase in radiodensity. What are the next considerations

A

Consolidation
Atelectasis
Tumor

136
Q

With acute pulmonary infections

A

Staph aureus pneumonia produces pneumatocele in children

137
Q

Complications of honeycomb lung

A

Cor pulmonale

138
Q

Hypersensitivity pneumonitits which is intrinsic allergic alveolitis is associated with

A

Bird fanciers lung

Humidifier lung

139
Q

Which accessory fissure anatomically is made up of 4 pleural layers

A

Azygous fissue

140
Q

Which 2 of the following would be associated with egg shell lymph node calcificiation

A

Silicosis

Sarcoidosis

141
Q

The superior accessory fissure

A

Divides RLL into 4 basilar segement and 1 sup segment

Splits LLLL segment from basilar segments

142
Q

Aspiration pneumonitis has an affinity for

A

Lower lobes

143
Q

Kartageners bronchiectasis may have associated

A

Sitis and bursus totalis commonly in the RLL

144
Q

TB is

A

Apical pleural calcification

145
Q

Streptococcus pneumonia

A

Most common acute bacterial infection

146
Q

When the lingula is atelectatic the

A

Left cardiac border is usually obliterated

147
Q

What is the principle mechanism for atelectasis with a large hilar related neoplasm

A

Obstructive (or resorption)

148
Q

Which fothe following asbestosis signs is considered virtually pathognomonic

A

Linear diaphragmatic pleural calcification

149
Q

Erasmus syndrome

A

CWP with scleroderma

150
Q

Pelural calcification and thickening would suggest the possibility of previeous

A

TB

151
Q

High speed deceleration trauma to the chest may result in pulmonary contusion or

A

Bilateral medullary lung opacification

152
Q

Which is in the subdifferential of multiple pulmonary cavitations

A

Hematogenous metastasis

153
Q

Which if not true regarding stap pneumonia

A

Begins peripherally in teh lung

154
Q

Silhouette sign is caused by

A

Water density lesion in anatomic contact with the herat aorta or diaphragm

155
Q

The chest x-ray may be normal with

A

Acute bronchitis

156
Q

Which fo the following is not a consoildation sign

A

Hilar displacement towards increasing density

157
Q

Air bronchogram sign

A

Physical air filled bronchi surrounded by opacified lung

158
Q

Which pulmonary cavitation cuase is not related to tissue necrosis

A

Rheumatoid nodule

159
Q

Kerley’s an and b lines are indicative of

A

Interstitial disease

160
Q

Metastasis to the lung in thyroid cancer will present as

A

Multiple evenly distributed nodules 3-5 in size

161
Q

Localized hyperlucency could be associated with all of the following except

A

Emphysema (pneumothorax, pneumatocele, foregin object aspiration)

162
Q

The most common causes for air space consolidation are

A 
Blood
Pus
Water
Cells
Protein
163
Q

Upper left heart border silhouette sign may be produced by

A

LUL #4 pneumonia

164
Q

Suspected pleural effusion on a full inspiration PA chest view could be confirmed by

A

Lateral decubitus with involved side down

165
Q

Most common cause for adult resorption atelectasis is

A

Bronchogenic cancer

Children = foreign object aspiration

166
Q

2 RUL

A

Ascending aorta

167
Q

5 RML

A

Heart (RA)

168
Q

1-3 LUL

A

Aortic knob

169
Q

2 LUL

A

Pulmonary artery

170
Q

4 LUL

A

Left atrium

171
Q

5 LUL

A

Left ventricle

172
Q

6 LUL

A

Upper descending aorta

173
Q

7-10 LUL

A

Diaphragm

Soft A (6 decks)

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